Kornerup Linda Skibsted, Kraglund Frederik, Feldt-Rasmussen Ulla, Jepsen Peter, Vilstrup Hendrik
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.
Gastrointest Tumors. 2021 Nov 4;9(1):37-42. doi: 10.1159/000520679. eCollection 2022 Mar.
Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer mortality worldwide. Recent animal studies suggest that thyroid hormone treatment improves HCC prognosis. The aim of this study was to describe the association between thyroid disease and HCC prognosis in humans.
We performed a nationwide cohort study including all persons with an HCC diagnosis from 2000 to 2018. Patients' age, sex, HCC treatment, and diagnoses of thyrotoxicosis, nontoxic goiter, and myxedema were obtained from Danish national healthcare registries. We used regression models to examine the association between thyroid disease and mortality hazard and restricted mean survival time after HCC diagnosis, adjusting for confounding by sex and age.
We included 4,812 patients with HCC and 107 patients with thyroid disease. Median follow-up time was 5 months (total 5,985 person-years). The adjusted mortality hazard ratio was 0.68 (95% CI: 0.47-0.96) for thyrotoxicosis and 0.60 (95% CI: 0.41-0.88) for nontoxic goiter. The restricted mean survival time during the 5 years following HCC diagnosis was 6.8 months (95% CI: 1.1-12.6) longer for HCC patients with thyrotoxicosis than for patients without thyroid disease, and it was 6.9 months (95% CI: 0.9-12.9) longer for HCC patients with nontoxic goiter than for patients without thyroid disease.
In this large nationwide cohort study, thyrotoxicosis and nontoxic goiter were associated with prolonged HCC survival.
肝细胞癌（HCC）是全球癌症死亡的第四大主要原因。最近的动物研究表明，甲状腺激素治疗可改善HCC的预后。本研究的目的是描述人类甲状腺疾病与HCC预后之间的关联。
我们进行了一项全国性队列研究，纳入了2000年至2018年期间所有被诊断为HCC的患者。患者的年龄、性别、HCC治疗情况以及甲状腺毒症、非毒性甲状腺肿和黏液性水肿的诊断信息均来自丹麦国家医疗保健登记处。我们使用回归模型来检验甲状腺疾病与HCC诊断后的死亡风险和受限平均生存时间之间的关联，并对性别和年龄的混杂因素进行了调整。
我们纳入了4812例HCC患者和107例甲状腺疾病患者。中位随访时间为5个月（总计5985人年）。甲状腺毒症的调整后死亡风险比为0.68（95%CI：0.47-0.96），非毒性甲状腺肿的调整后死亡风险比为0.60（95%CI：0.41-0.88）。HCC诊断后5年内，甲状腺毒症的HCC患者的受限平均生存时间比无甲状腺疾病的患者长6.8个月（95%CI：1.1-12.6），非毒性甲状腺肿的HCC患者的受限平均生存时间比无甲状腺疾病的患者长6.9个月（95%CI：0.9-12.9）。
在这项大型全国性队列研究中，甲状腺毒症和非毒性甲状腺肿与HCC患者生存期延长有关。
